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The Royal College of Psychiatrists Improving the lives of people with mental illness

Smashed

Introduction

Smashed, directed by James Ponsoldt, was released in the UK in December 2012. It tells the story of a young married childless couple, Kate and Charlie Hannah, whose relationship centers around drinking alcohol. Kate, played very convincingly by Mary Elizabeth Winstead, manages to function as a primary school teacher until several alcohol related harmful incidents cause her to question this lifestyle and she seeks sobriety. Unfortunately this choice has implications for her husband Charlie, played by Aaron Paul (of Breaking Bad fame), who remains addicted and sees no reason to change, putting their relationship under great strain.

Smashed was very well received by critics and audiences, and got some extremely good reviews from former addicts who commented on its authentic portrait of alcohol dependence. It is particularly useful as an educational film for patients seeking help and for professionals engaged in providing that support and treatment.

The Film

Smashed opens with Kate taking a quick drink as she showers before heading off to work as an infant school teacher. She notes that she’s wet the bed again too. When she reaches the school car park, she takes a swig from her flask to get her started for the day. Her husband Charlie works from home as a rock music journalist and leads a less pressured existence, so he stays sleeping in bed, finding it hard to get up. Kate appears to be coping fine until she finds herself unexpectedly vomiting in front of her class of young children, some of whom ask if she is pregnant. Kate sees this as an immediate solution to her dilemma and lies to them confirming that she is indeed pregnant. The news travels fast to the principal, a woman who cannot have her own children, and so becomes invested in Kate’s seemingly positive news. However, a male colleague, Dave Davies, who is a recovering alcoholic, quickly detects the truth about Kate and offers her a route to sobriety through attendance at his Alcoholics Anonymous group, without betraying her trust. Kate is initially unsure about seeking help in this way, but after a drunken night out on the ‘wrong side of town’ involving the consumption of crack cocaine and a night sleeping rough, she finds the motivation.

When she first accompanies Dave to his AA group she meets an older woman, Jenny, who becomes her mentor and a positive influence in her life. Unfortunately Dave flirts clumsily with Kate on the way home after the meeting, Kate deals with this firmly and effectively, stating her loyalty to Charlie. As Kate begins to feel pride in her sobriety, her relationship with Charlie suffers because of his continued drinking and the lifestyle that is associated with it. Kate decides to visit her mother for the first time in years and Charlie insists on going with her. Kate’s mother is revealed as a drinker, embittered by the breakup of her own marriage and the sobriety of her ex-husband who now has a new family. The tensions in their mother-daughter relationship are very apparent.

When Kate is finally forced to reveal the truth about her non-existant pregnancy to the principal at school, she loses her job, causing a brief relapse of her drinking. However, she gets back on track with the help of Jenny and Dave and faces the reality about the impossibility of marriage to Charlie if he continues to drink. The final scene jumps forward a year when the couple meets again after Kate has been sober for a year. Charlie, who is still drinking, wants to give their relationship another try but she sees that he has not changed and knows that it is over for her.

 

Relevance to the Field of Mental Health

With increasing recognition of the role that excess alcohol consumption plays in the physical and mental ill health of individuals, this film portrays a very important problem that currently faces our society.

Smashed gives a compellingly believable presentation of two individuals with alcohol use disorders and follows Kate through her attempt to get help using Alcoholics Anonymous. The film could be used to teach about the subject, perhaps alongside a reading of a recent Clinical Review published on 21st February 2015 in the BMJ, written by Ed Day, Alex Copello and Martyn Hull, called Assessment and management of alcohol use disorders (BMJ2015;350:h715). The article is aimed at GPs and non-specialist hospital doctors and an abstract is freely available as well as a 30-minute discussion about the topic with the authors of the review (which can be heard as an audio track on soundcloud).


Psychiatrists might find it informative to read two recent articles in BJPsych Advances on the subject of drug and alcohol addiction, by Jason Luty. The first entitled Drug and alcohol addiction: new pharmacotherapies (10.1192/apt.bp.114.013367) and the second called Drug and alcohol addiction: do psychosocial treatments work? (10.1192/apt.bp.114.013177). There is also a recent CPD online learning module called Alcohol-related brain damage that would provide an additional useful resource.

Lastly, the charity Alcohol Research UK funds high quality research into alcohol-related harm and hosts many useful resources at their website.

• More information about Smashed can be found at IMDB, as can a short trailer.

Smashed is available to purchase from amazon.co.uk

• Minds on Film is written by Consultant Psychiatrist, Dr Joyce Almeida

 

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About this blog

 

Minds on Film is a monthly blog that explores psychiatric conditions and mental health issues as portrayed in a selection of readily available films.

Please note that this blog may contain plot spoilers. Any views expressed are purely my own.

Dr Joyce Almeida
Dr Almeida is a consultant
psychiatrist working in the private sector in the UK.